If you are at your wits’ end with your unsuccessful breast-feeding attempts or your wailing newborn, you would probably want to give Ms Betty Lee a call. Betty has started off as a nurse in a local hospital and later risen to become ward sister, before eventually finding her calling as a lactation consultant. All in all, she has more than 30 years of experience as a registered nurse, midwife and lactation consultant. Now she provides personal service to mums and babies in the comfort of their homes. She also contributes regularly to parenting articles, and lends her expertise and advice to various popular parenting magazines.
“If the physiological needs of the baby are met during the day, it will sleep better at night.”
Going back to work
When asked about the main challenges/problems faced by breast-feeding mothers today, Betty notes that mothers nowadays are more well-read and have the basic knowledge about breast-feeding, but many find it difficult to cope with breast-feeding when they need to return to the workforce after their maternity leave. To continue breast-feeding, mothers will have to find a way to pump out milk at work and store it properly. If a routine has already been set up for the baby, it would be easier for both the mother and the baby. Babies are to be fed at regular intervals (2 or 3 hours depending on the babies) during the day, even if it means waking up the babies to do so. Betty adds: “If the physiological needs of the baby are met during the day, it will sleep better at night. During the night, let the baby wake you up for the feed, not the other way round.” In this way, mothers can have their badly needed rest.
As for the switch from breast to bottles, she says: “We should start bottle-feeding the baby only when the baby has already been on direct feed from the breasts for at least two months. Mothers can start bottle-feeding once per day two to three weeks before returning to work.” Betty encourages all mothers to try to at least breastfeed for six months because that is the period when the infants get the most out of breast milk to boost their immunity systems. Interestingly, she points out that breast milk has such good healing ability that it was used on sore eyes and other sore areas in the past by the older generation. She also advocates mothers to breastfeed for as long as they want, even up to 3 years, which can create strong bonding between mother and child. She reminds: “There is still nutrition in the breast milk for the baby even when it is older.”
“Mothers can only produce about 67ml of colostrum in 24hrs in the first three days.”
Not enough milk?
Many mothers are plagued by the notion that they don’t have enough milk for their babies. Betty advises mothers not to be weighed down by this because it will give the body the wrong message. She supports this statement by providing some figures that should put some worrying mothers in perspective. She says: “Mothers can only produce about 67ml of colostrum* in 24hrs during the first three days. The baby doesn’t require much milk during these few days, because its stomach then is just the size of a marble.” She adds: “Around the fifth day, the milk will come, and that’s when the breasts are full and engorgement may set in.”
“…the let-down reflex is triggered when mother is in a relaxed state…”
To maintain a good supply of milk, Betty says: “First, mothers must eat well to have good nutrition. Other supplements can come in the form of fenugreek, green papaya fish soup or even doctor medication which mainly helps the mother to relax.” The lesson learnt is that if the let-down reflex is triggered when mother is in a relaxed state, then it is even more important that the mother should not get worked up over our milk supply. Otherwise, she will get herself trapped in a vicious cycle. To stimulate milk supply, babies must empty one breast before going on to the other. If the baby is weak in sucking or has small appetite, then the mother should use pump to empty the breasts of the remaining milk.
There are two types of treatment for engorgement. She explains: “If it’s normal engorgement, use the “hot treatment” by placing hot towel on the nipple and areola so as to open the pores. If your breasts are very engorged, use the “cold treatment”. Firstly, place cold towels on the breasts (not nipple and areola) to relieve pain, then massage nipples and areolas to open up the pores before letting the baby suckle or using breast pump.”
“If the milk is slow and the baby gets impatient, try breast compression.”
To encourage latch-on
We have heard of mothers spreading honey on nipples to encourage babies to latch on, but Betty doesn’t approve of it. She says, “It’s better to squeeze a bit of breast milk out, and spread it on the nipple instead.” If the milk is slow and the baby gets impatient, try breast compression. “While baby is suckling, press on your breast to help to squeeze out milk. When baby stops feeding, you should stop the compression too so that he doesn’t get the idea that there’s milk even when he’s not trying,” says Betty. She suggests: “ While you are still in the hospital after birth, do ask for a lactation consultant to show you how to let the baby have a good latch-on. Babies are smart, once they are shown how to do it a couple of times, they will pick it up easily after that.” With a good latch-on, meaning it is taking in the whole areola instead of just the nipple, the mother should not suffer from sore nipples. Betty also goes on to talk about how to get babies who are already on bottles to go back to breast-feeding by using nipple shields and supplemental feeding tube device to trick the baby to go back to breast-feeding.
“…for the first two weeks, a feed can be as long as 45 minutes to 1 hour…”
How long should we breastfeed?
“Generally, for the first two weeks, a feed can be as long as 45 minutes to 1 hour but don’t go beyond 1 hour. During the third and forth week, it’s shorten to 20 to 30 minutes. Gradually it gets shorter. When we reach the third month, it can be as short as 15 minutes,” Betty says. As for the interval between feeds, it gets longer when the baby feeds better. For the first two weeks to one month, the interval can be as short as one and half hour.
Being a mother who has breastfed all my three boys, I faced a big problem weaning my youngest son who was on my breasts for two years. On this subject, Betty says: “Most of the time, it’s the mothers who find it difficult to let go, not the baby.” It is basically a matter of tearing yourself away from the baby for three days and letting him cry. “The baby will be fine after that,” she assures. I cannot agree more because as a last resort I took a short holiday without the baby, and it worked!
“Just do it!”
Betty has shared with me two motivating stories. One of them is about a mother who has flat nipples. She was told by her doctor that she could not breastfeed her child. She had to pump out her milk for eight months to feed her baby. When her second child came, she wanted to try direct feed and Betty was called in to help. After trying for some time, amazingly the baby adapted to her nipples and she breastfed for three years. What Betty is trying to tell mothers is that if your mind is set on breast-feeding, then “just do it!” Anything is possible if you persevere. Another case involves an American mother in Nepal. Because of her concern about the quality of water in Nepal, she set her mind on breast-feeding. However she had to grapple with problems like sore nipples and other infections. But she refused to give up and even went against her doctor’s advice. Miraculously, her nipples healed by themselves and she breastfed for two years. “It was sheer will power on the part of the mother,” Betty says.
“Take one day at a time, relax and don’t be anxious.”
Throughout the interview, Betty is patient, warm and approachable. She has put me at ease so much that I bombarded her with more questions than I set out to. A last note for the mothers who cannot figure out why their babies are unhappy or who just cannot get the hang of breast-feeding, do seek the help of a lactation consultant. It is best that she pays you a personal visit to assess your situation and then give you the right advice. Before we parted, I asked whether Betty has anything more to say to our readers, she says: “Take one day at a time, don’t be too tense.” I guess that sums up the right attitude towards breast-feeding – enjoy it!
Miss Betty can be contacted at her mobile 98330170. For lactation consultation, her charges is $100 per hour. For baby massage, it’s $200 for 2 sessions (1 1/2 to 2hrs). She also conducts parent craft classes.
*Colostrum is produced during the first 72 hours after delivery. It is a thin, and rich yellow fluid made up of essential nutrients such as antibodies, immunoglobulin and essential vitamins and nutrients for the first few days of baby's life. Its laxative property helps to move out the meconium stool and may help to reduce jaundice.